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The in vitro Activity of Echinocandins Against Clinical Trichophyton rubrum Isolates and Review of the Susceptibility of T. rubrum to Echinocandins Worldwide

Summary

Researchers tested how well three antifungal drugs (micafungin, anidulafungin, and caspofungin) work against a common fungus that causes skin infections. They found that two of these drugs were more effective than the third, suggesting they could be helpful alternatives when standard treatments fail due to drug-resistant fungal strains. The study also reviewed similar research worldwide and found consistent results across different testing methods.

Background

Trichophyton rubrum is the most common dermatophyte species causing dermatomycosis, a prevalent superficial fungal infection affecting keratinized tissues. Resistance to azoles and terbinafine has increased globally, necessitating exploration of novel antifungal agents. Echinocandins have shown in vitro activity against dermatophytes but clinical data remain limited.

Objective

To evaluate the in vitro antifungal activity of three echinocandins (anidulafungin, caspofungin, and micafungin) against 73 clinical T. rubrum isolates from China using EUCAST E.DEF 9.3.1 methodology. The study also reviewed global literature on T. rubrum susceptibility to echinocandins.

Results

Micafungin demonstrated the lowest modal MEC value (0.008 mg/L) and geometric mean MEC (0.014 mg/L), followed by anidulafungin (modal MEC 0.016 mg/L, GM 0.018 mg/L) and caspofungin (modal MEC 0.5 mg/L, GM 0.308 mg/L). Literature review of five additional studies confirmed similar results, with micafungin and anidulafungin showing greater potency than caspofungin against T. rubrum.

Conclusion

Echinocandins exhibit excellent in vitro activity against T. rubrum, with micafungin and anidulafungin demonstrating superior potency compared to caspofungin. These findings suggest echinocandins could serve as potential treatment options for recalcitrant dermatophytoses caused by resistant strains. However, further clinical investigations are necessary to establish in vivo efficacy.
  • Published in:Infectious Diseases and Resistance (Infect Drug Resist),
  • Study Type:In vitro Susceptibility Study with Systematic Literature Review,
  • Source: PMID: 37621698
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